CoChat
Sign Up
Cited by 127Gastroesophageal reflux and treatmentsHelicobacter pylori-related gastroenterology studiesGastrointestinal motility and disorders

Pharmacological and pharmacodynamic essentials of H2-receptor antagonists and proton pump inhibitors for the practising physician

Huang, Jia-Qing, Hunt, Richard H.·2001·Best Practice & Research Clinical Gastroenterology
DOI 10.1053/bega.2001.0184
Open this paper in CoChat — free account

Abstract

The suppression of gastric acid secretion with anti-secretory agents has been the mainstay of medical treatment for patients with acid-related disorders. Although the majority of Helicobacter pylori -related peptic ulcers can be healed with antibiotics, ulcer healing and symptom control can be significantly improved when antibiotics are given with anti-secretory agents, especially with a proton pump inhibitor. There is a dynamic relationship between the suppression of intragastric acidity and the healing of peptic ulcer and erosive oesophagitis and control of acid-related symptoms. The suppression of gastric acid secretion achieved with H(2)-receptor antagonists has, however, proved to be suboptimal for effectively controlling acid-related disorders, especially for healing erosive oesophagitis and for the relief of reflux symptoms. H(2)-receptor antagonists are also not effective in inhibiting meal-stimulated acid secretion, which is required for managing patients with erosive oesophagitis. Furthermore, the rapid development of tolerance to H(2)-receptor antagonists and the rebound acid hypersecretion after the withdrawal of an H(2)-receptor antagonist further limit their clinical use. Although low-dose H(2)-receptor antagonists are currently available as over-the-counter medications for self-controlling acid-related symptoms, their pharmacology and pharmacodynamics have not been well studied, especially in the self-medicating population. Proton pump inhibitors have been proved to be very effective for suppressing intragastric acidity to all known stimuli, although variations exist in the rapidity of onset of action and the potency of acid inhibition after oral administration at the approved therapeutic doses, which may have important clinical implications for the treatment of gastro-oesophageal reflux disease and perhaps for eradicating H. pylori infection when a proton pump inhibitor is given with antibiotics. Once-daily dosing in the morning is more effective than dosing in the evening for all proton pump inhibitors with respect to the suppression of intragastric acidity and daytime gastric acid secretion in particular, which may result from a better bio-availability being achieved with the morning dose. When higher doses are needed, these drugs must be given twice daily to achieve the optimal suppression of 24 hour intragastric acidity. Preliminary results have shown that esomeprazole, the optical isomer of omeprazole, given at 40 mg, is significantly more effective than omeprazole 40 mg, lansoprazole 30 mg or pantoprazole 40 mg for suppressing gastric acid secretion. However, more studies in different patient populations are needed to compare esomeprazole with the existing proton pump inhibitors with regard to their efficacy, cost-effectiveness and long-term safety for the management of acid-related disorders.

Integrity signals

Registry

Crossref · 10.1053/bega.2001.0184

Cites

93 of 93 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • PPIs have unfavorable effects on gastric functions and host defensive mechanisms, causing delayed gastric emptying, decreased gastric mucus viscosity, increased bacterial load and increased bacterial translocation.

    “PPIs have unfavorable effects on gastric functions and host defensive mechanisms, causing delayed gastric emptying, decreased gastric mucus viscosity, increased bacterial load and increased bacterial translocation[55-57].”

    From Proton pump inhibitors and dysbiosis: current knowledge and aspects to be clarified (2019) · cites this paper as [56]

Cites

Flagged first, then by citations

4 of the 97 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Huang, J.-Q., & Hunt, R. H.
Affiliations
McMaster University Medical Centre (CA)
ORCID
Hunt, Richard H.
Venue
Best Practice & Research Clinical Gastroenterology
Publisher
Elsevier BV
Published
2001-06
Volume
15
Issue
3
Pages
355-370
ISSN
1521-6918 (ISSN-L)
DOI
10.1053/bega.2001.0184
OpenAlex
W2075215328
Cited by
127
References
97
Citations by year
2026: 2 · 2025: 6 · 2024: 6 · 2023: 4 · 2022: 3 · 2021: 4 · 2020: 2 · 2019: 9 · 2018: 4 · 2017: 2 · 2016: 9 · 2015: 4 · 2014: 5 · 2013: 4 · 2012: 5
FWCI
1.48
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Best Practice & Research Clinical Gastroenterology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
  • Health Sciences › Medicine › Surgery › Helicobacter pylori-related gastroenterology studies
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Keywords
H2 receptor antagonists, proton pump inhibitors, gastric acid secretion, acid-related diseases, gastroesophageal reflux disease, erosive esophagitis, peptic ulcer, Helicobacter pylori eradication, omeprazole, esomeprazole, lansoprazole, pantoprazole, drug tolerance
MeSH terms
Anti-Ulcer Agents, Drug Therapy, Combination, Gastric Acid, Gastroesophageal Reflux, Histamine H2 Antagonists, Humans, Peptic Ulcer, Proton Pumps, Proton Pump Inhibitors

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review